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Cardiac involvement in collagen diseases
S T Toumanidis1, C M Papamichael, L G Antoniades
1Department of Clinical Therapeutics, Medical School of Athens University, Alexandra Hospital, Greece.
European Heart Journal
|February 1, 1995
Summary
Collagen diseases like progressive systemic sclerosis can cause early heart abnormalities, including left ventricular hypertrophy and reduced ejection fraction. Rheumatoid arthritis patients may exhibit predominant valve dysfunction.
Area of Science:
- Cardiology
- Rheumatology
- Echocardiography
Background:
- Collagen diseases can affect multiple organs, including the heart.
- Early detection of cardiac involvement is crucial for managing these conditions.
- Patients often lack traditional cardiovascular risk factors or overt symptoms.
Purpose of the Study:
- To identify early cardiac morphological and functional changes in patients with collagen diseases.
- To differentiate cardiac manifestations among various collagen diseases.
- To assess cardiac function at rest and during isometric exercise.
Main Methods:
- Echocardiography was performed on 62 patients with collagen diseases (systemic sclerosis, lupus erythematosus, rheumatoid arthritis, dermatomyositis) and 40 healthy controls.
- Measurements included global and regional left ventricular ejection fraction at rest and during handgrip isometric exercise.
- Analysis focused on left ventricular mass, ejection fraction, and valve function.
Main Results:
- Progressive systemic sclerosis patients showed significantly higher left ventricular mass index and the lowest ejection fraction.
- All collagen disease groups exhibited interventricular septum dysfunction during isometric exercise.
- Rheumatoid arthritis patients displayed reduced mitral and aortic valve leaflet separation.
Conclusions:
- Progressive systemic sclerosis is associated with left ventricular hypertrophy and reduced ejection fraction.
- Rheumatoid arthritis patients primarily present with valvular dysfunction.
- Echocardiography can detect subclinical cardiac abnormalities in collagen vascular diseases.
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